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Individual

SUSANA PESTANA-SZWARC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
145 MAPLE AVE, RED BANK, NJ 07701-1717
(732) 747-9660
Mailing address
315 EASTBOURNE AVE, LONG BRANCH, NJ 07740-5501

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21-0634494
NJ
Enumeration date
12/18/2014
Last updated
12/18/2014
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